MEDICARE: PHERICA FONTENETTE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	44861	TX

General Provider Information

NPI Number	:	1306792338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHERICA FONTENETTE

Provider Business Mailing Address
First Line	:	3335 RANCHO GRANDE
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78224-1056
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3335 RANCHO GRANDE
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78224-1056
Country	:	US
Telephone Number	:	337-342-9673
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2026
Last Update Date	:	03/10/2026

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Directions to “ PHERICA FONTENETTE ” Practice Location

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